The Story in Your Eyes

by Nissa Hallquist

Vision is one thing many people take for granted until it's too late. For optimum eye health, you should keep in mind four factors: damage, disease, degeneration, and refractive errors.

Damage

Positioned front and center, the eye is particularly susceptible to injury at work, home, and when participating in sports. That's why it's so important to be mindful of potential hazards. To avoid retinal detachment, burns, impact, or impalement of the eye, always wear protective eyewear when using any sort of power tool or corrosive solvents. Depending on the sport being played, use protective goggles or a helmet with a face shield.

More common lately are issues of eye strain. Staring at the computer for hours on end at the office, watching TV, and being out in the bright sun can take its toll. Ways to minimize eye strain during the former two situations include sitting at least twenty-four inches from the screen, adjusting screen brightness to a comfortable level, and adjusting surrounding ambient light to minimize glare. If your eyes feel strained or scratchy, simply look away for a few minutes. When outside, wear sunglasses and/or a wide-brimmed hat to protect eyes from the sun's glare and harmful UV rays.

Disease (Infection)

Exposed as they are to the elements, eyes can be prone to infection. Probably the most common of these are conjunctivitis (pink eye, a very contagious infection) and styes (bumps on the eyelid caused by bacteria entering eyelash hair follicles). Other afflictions of the eye include keratisis (bacterial, fungal, or herpes infection of the cornea), dry eye, retinitis pigmetosa (RP), and uveitis (swelling of the uvea, or middle layer of the eye; often associated with autoimmune disorders).

Treatments for eye infections vary based on type and extent, but generally involve compresses, antibiotics, and/or topical medications, such as gels or drops. Keeping eyes clean and hydrated and washing your hands before touching your eyes are the best ways to prevent infections from happening.

Degeneration

Related to disease, degenerative conditions of the eye tend to be the inevitable result of time and normal "wear and tear." Even those with perfect vision can expect at least some deterioration of visual acuity as time goes on. Signs that your vision may be deteriorating include: trouble focusing on objects near or far, trouble adjusting to darkness, sensitivity to light, seeing spots or wavy lines and, of course, any pain.

Specific degenerative conditions include presbyopia (inability to focus close-up), cataracts (clouding of the eye's lens), glaucoma (optic nerve damage caused by increased fluid pressure), and age-related macular degeneration (AMD; loss of sharp central vision). Early diagnosis and treatment of such conditions can slow down or even stop their progression. Treatments range from prescription glasses to surgery.

Refractive Errors

Not damage, and not technically a disease, refractive errors involve an irregularly shaped cornea. Depending on how the cornea is misshapen, the results can be myopia (nearsightedness), hyperopia (farsightedness), astigmatism (trouble focusing), or presbyopia.

The extent of a refractive error is judged via a standardized vision test. This is done by reading a series of figures set at a distance of twenty feet, which is where the standard of 20/20 vision came from (in other words, you can see clearly at twenty feet what you should normally be able to see).

Refractive errors can be artificially corrected with glasses or contact lenses, the strength based on the results of the aforementioned eye test, to bring vision back as close to 20/20 as possible. If such appliances aren't appealing, you now have the option of laser surgery to correct the error at the source. Or, if the error isn't too severe, it can actually be improved through vision therapy.

Consult your local ophthalmologist, or contact the following organizations for more information regarding eye health:

American Academy of Ophthalmology
San Francisco, CA, (415) 561-8500, www.aao.org

American Optometric Association
St. Louis, MO, (800) 365-2219, www.aoa.org

Eye Surgery Education Council
(703) 788-5761, www.eyesurgeryeducation.com

National Eye Institute
Bethesda, MD, (301) 496-5248, www.nei.nih.gov

Prevent Blindness America
Chicago, IL, (800) 331-2020, www.preventblindness.org

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Laser Eye Surgery Q&A

If you’d rather not wear contacts or glasses to correct your vision, laser eye surgery could be the answer.
  • A laser in my eye? Really?
    It may sound scary. But, considering the latest advancements that have been made in medical technology, using a laser is actually one of the safest ways to correct vision.
  • What conditions does laser eye surgery correct?
    It is generally used to permanently correct refractive errors of the eye, including near and farsightedness, astigmatism, and presbyopia.
  • What is LASIK?
    LASIK stands for laser-assisted in situ keratomileusis. It is currently the most common laser eye surgery procedure.
  • How does it work?
    A laser is used to precisely reshape the cornea, the clear front part of the eye. Emitting pulses of concentrated, cool, invisible ultraviolet light, the laser removes extremely tiny amounts of tissue (25 100,000ths of a millimeter) at a time, without disturbing any surrounding tissue.
  • What is Wavefront vs. conventional LASIK?
    Conventional LASIK corrects the main types of refractive errors based on the established prescription of glasses or contacts. Wavefront-optimized LASIK also takes into account the natural curvature and characteristics of an individual’s eye, and so can also correct higher order aberrations, such as halos, double vision, and night vision. Wavefront-guided LASIK is used when such higher order aberrations are severe.
  • What is the success rate?
    According to the Eye Surgery Education Council: 98 percent of those with mild to moderate nearsightedness experienced 20/20 vision a year after the surgery, and 100 percent achieved 20/40 vision. 86 percent of those with extreme nearsightedness had 20/20 vision, 100 percent 20/40. Mild to moderate farsightedness: 72 percent had 20/20 vision after nine months, 95 percent had 20/40 or better. (Severe farsightedness was contraindicated.) Similar good results were observed with astigmatism and presbyopia. All in all, 95.4 percent of patients would recommend it.
  • When is LASIK contraindicated?
    If cost is an issue (since it’s still considered elective surgery and not generally covered by insurance), you have or recently had an eye disease or injury, if you have an autoimmune disease, or are taking medication that could compromise healing.